Session Time: 2:00pm-2:45pm
Location: Research Hub - Live Theater
Disclosures: Richard J. Batka, MD: No financial relationships or conflicts of interest
Objective: There are few data examining the impact of recurrent stroke (RS) on inpatient rehabilitation unit (IRU) outcomes. We hypothesized groups of persons with first-ever stroke (FES) would have superior home discharge destination (DD) rates and functional outcomes compared to RS.
Design: Retrospective cohort.
Setting: IRU in an urban, academic medical center.
Participants: The sample was 405 consecutive stroke admissions with a mean (SD) age=69.7(14.8) years, National Institutes of Health Stroke Score (NIHSS)(8.0)(6.8), days to admission (DTA) of 10.2(9.7, rehabilitation length of stay (RLOS)=14.3(8.1)d, and total admission functional independence measure (aFIM)=59.2(20.2) and 46.9% were female.
Main Outcome Measures: DD (home versus other) and change in the total (cFIM), motor (cFIM-M) and cognitive (cFIM-C) FIM scores from admission to discharge. Hypothesis testing utilized Chi-Square test for DD and repeated-measures (mixed design) analysis of variance (ANOVA) for cFIM.
Results: There were 304 (75%) and 101(25%) subjects in the FES and RS groups, respectively. There were no significant group differences in sex, NIHSS, DTA, RLOS or aFIM, but age was borderline (P-=.053). The DD rate to home was slightly higher for FES (67 v. 61%), but not statistically significant (P=.322) However, the mean functional gains were higher in the FES group for cFIM (x=22.4 v. 16; P=.004), cFIM-M (20.4 v. 15.6, P=.006), and cFIM-C (x=1.6 v. 0.4, P=.039).
Conclusions: Even though similar at baseline, there were greater FIM gains (total, motor and cognitive) in the FES compared to the RS group. Despite this, home DD rates were roughly similar. Less residual cerebral capacity in the RS group could undermine functional gains on an IRU. However, patients and families may be already accustomed to a decreased functional status and prepared for home discharge. Further research should explore differences in outcomes after IRU discharge and factors predicting home d/c in RS.
Level of Evidence: Level III
To cite this abstract in AMA style:Batka RJ, Jaywant A, Nuñez AR, Toglia J, O'Dell MW. Discharge Disposition and Functional Independence Measures in First-Ever Versus Recurrent Stroke [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/discharge-disposition-and-functional-independence-measures-in-first-ever-versus-recurrent-stroke/. Accessed December 9, 2023.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/discharge-disposition-and-functional-independence-measures-in-first-ever-versus-recurrent-stroke/